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Saving or Creating: Which Are We Doing When We Resuscitate Extremely Preterm Infants?
1a Johns Hopkins University.
Insights
Resuscitating extremely preterm infants in neonatal intensive care units (NICUs) is controversial. This article argues that interventions before viability are more akin to creation than rescue, challenging the moral urgency of such procedures.
Area of Science:
- Neonatal Medicine
- Medical Ethics
- Bioethics
Background:
- Neonatal intensive care units (NICUs) are medical advancements with ethical controversies.
- The resuscitation of extremely preterm infants is a particularly debated issue.
- US physicians generally resuscitate infants from 22-25 weeks gestation.
Purpose of the Study:
- To question the moral imperative to resuscitate extremely preterm infants.
- To challenge the notion that such interventions constitute "saving" a life.
- To reframe the ethical consideration of medical intervention in early human development.
Main Methods:
- Philosophical analysis of medical intervention.
- Ethical critique of the concept of "saving" vs. "creating" life.
- Examination of the moral urgency associated with rescue versus creation.
Main Results:
- Medical advancements allow intervention before viability, blurring the line between saving and creating life.
- Resuscitating extremely preterm infants is argued to be an act of creation, not rescue.
- The moral urgency of rescue is significantly higher than that of creation.
Conclusions:
- The ethical framework for resuscitating extremely preterm infants needs re-evaluation.
- Interventions on non-viable fetuses should be viewed as creation, not rescue.
- This distinction impacts the moral obligations of healthcare providers in neonatal intensive care.
Abstract:
Neonatal intensive care units represent simultaneously one of the great success stories of modern medicine, and one of its most controversial developments. One particularly controversial issue is the resuscitation of extremely preterm infants. Physicians in the United States generally accept that they are required to resuscitate infants born as early as 25 weeks and that it is permissible to resuscitate as early as 22 weeks. In this article, I question the moral pressure to resuscitate by criticizing the idea that resuscitation in this context "saves" a human life. Our radical medical advancements have allowed us to intervene in the life of a human before it makes sense to say that such an intervention "saves" someone; rather, what the physician does in resuscitating and treating an extremely preterm infant is to take over creating it. This matters, I argue, because "rescues" are much more morally urgent than "creations."
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